Identifying predictors of return to work and the duration of time off work in first responders affected with musculoskeletal injuries or mental health issues.

PURPOSE: To identify predictors of return to work, duration of time off work, and claim closure for first responders experiencing injuries or illnesses, and summarize the claim data. METHODS: First responder claims collected between January 2012 and July 2017 were obtained from a disability management company. Known predictors of return to work were extracted from the data including age, sex, diagnosis, years of service, claim lag, medical report lag, and the return-to-work duties. Survival analyses were performed to identify predictors of return to work and claim closure using the Cox proportional regression analysis. Log-rank tests were performed to identify predictors that affected the rate of return to work and claim closure. Summary statistics were performed for the injury and return-to-work data. RESULTS: 60 of the 67 (89.6%) identified first responders returned to work within the data collection period. Musculoskeletal injuries predicted an increased likelihood of returning to work (hazard ratio = 2.0, 95%CI = 1.14-3.60) and a shorter duration of time off work (37 days on average) compared to mental health issues. Everyday of claim lag and medical report lag predicted a 2% decrease in likelihood of return to work. Returning to work was the only predictor of claim closure. 45 (67.2%) first responders returned to their pre-absence duties. 22 (32.8%) mental health claims and 45 (67.2%) injury claims were identified. CONCLUSIONS: 89.6% of first responders returned to work, although only 67.2% returned to their pre-absence duties. Predictors of return to work included injury type, as first responders with musculoskeletal injuries returned to work sooner, and claim and medical lag delayed the return to work.

Bioinformatic analysis suggests potential mechanisms underlying parasitoid venom evolution and function.

Hymenopteran parasitoid wasps are a diverse collection of species that infect arthropod hosts and use factors found in their venoms to manipulate host immune responses, physiology, and behaviour. Whole parasitoid venoms have been profiled using proteomic approaches, and here we present a bioinformatic characterization of the venom protein content from Ganaspis sp. 1, a parasitoid that infects flies of the genus Drosophila. We find evidence that diverse evolutionary processes including multifunctionalization, co-option, gene duplication, and horizontal gene transfer may be acting in concert to drive venom gene evolution in Ganaspis sp.1. One major role of parasitoid wasp venom is host immune evasion. We previously demonstrated that Ganaspis sp. 1 venom inhibits immune cell activation in infected Drosophila melanogaster hosts, and our current analysis has uncovered additional predicted virulence functions. Overall, this analysis represents an important step towards understanding the composition and activity of parasitoid wasp venoms.

International employee perspectives on disability management.

PURPOSE: To provide an international analysis of employees' views of the influence of disability management (DM) on the workplace. METHODOLOGY: An international research team with representation from Australia, Canada, China, and Switzerland collected survey data from employees in public and private companies in their respective regions. Due to lack of availability of current measures, a research team-created survey was used and a total of 1201 respondents were collected across the four countries. ANALYSIS: Multiple linear (enter) regression was also employed to predict DM's influence on job satisfaction, physical health, mental health, workplace morale and reduced sickness absence, from respondents' perceptions of whether their company provided disability prevention, stay-at-work, and return-to-work initiatives within their organization. One-way ANOVA comparisons were used to examine differences on demographic variables including company status (public versus private), union status (union versus nonunion), and gender. RESULTS: The perceived influence of DM programs was related to perceptions of job satisfaction; whereas, relationships with mental health, physical health, morale, and sickness absence were variable according to type of DM program and whether the response was related to self or others. Difference analyses (ANOVA) revealed significantly more positive perceptions for private and nonunion organizations; no gender effects were found. CONCLUSIONS: There is perceived value of DM from the perspective of employees, especially with respect to its value for coworkers. Implications for Rehabilitation Rehabilitation efforts should continue to focus attention on the value of disability management (DM). In particular, DM that is fully committed to the biopsychosocial model would be supported by this research. Employees reported the most value in the psychosocial variables addressed by DM, such that rehabilitation professionals could focus on these valued aspects to improve buy-in from employees. The interest in coworker value may provide another avenue for rehabilitation efforts to increase uptake, by highlighting the value of intervention efforts for employee coworkers. Rehabilitation professionals in union environments may need to be particularly cognizant of the need for encouraging psychosocial and coworker value potentially seen by employees in order to increase acceptance and participation for organizational DM efforts.

Attitudes towards disability management: A survey of employees returning to work and their supervisors.

OBJECTIVES: Return to work after a leave on disability is a common phenomenon, but little is known about the attitudes of employees or their supervisors towards the disability management process. We report on employee and supervisor feedback from one disability management experience. PARTICIPANTS: 389 consecutive employees from the Ontario offices of a single private Canadian insurance company returning to work from short-term disability, and their supervisors. METHODS: We surveyed employees and their supervisors about their experience with, and attitudes towards, the disability management process. RESULTS: Of those surveyed, 88 employees and 75 supervisors provided data (response rates of 22.6% and 19.3% respectively). The majority of respondents (79.1% of employees and supervisors) endorsed positive attitudes towards their disability management experience. More than 25% of employees disagreed with the following three items: case managers contributed to recovery, case managers removed barriers to recovery, and sufficient support was provided in the return to work process. More than 25% of employees and managers reported that a commitment to modify an unhelpful work situation was not followed through. CONCLUSION: The majority of participating employees returning to work from short-term disability, and their supervisors, reported a high level of satisfaction with the disability management process. Areas that may benefit from attention include some aspects of case manager-employee interaction and ensuring that support during the return to work process is provided, including modification to work situations when appropriate.

Identifying poor symptom control in Parkinson's disease.

The range of drugs available to treat people with Parkinson's disease has never been greater. However, patients still encounter difficulties in non-specialist settings where there is often confusion over drug selection, dosage and the timing of dosages. Small adjustments to the type of drug used, dosage and timing can have a significant impact on the control of Parkinson's disease and with it the quality of life of patients, carers and their families. This article provides a brief overview of Parkinson's disease including how to identify poor symptom control.

Integrating disability management into strategic plans: creating healthy organizations.

The integration of disability management into the strategic planning of a corporation ensures a work environment is created that motivates employees to consistently meet customer expectations. Disability management strategies can achieve significant decreases to the human and financial cost of workers' compensation, sick leave or short term disability, and long-term disability. The business case for disability management including effective return to work programs clearly supports program implementation to enhance employee engagement, delivery of corporate priorities, and improvement to the company's bottom line.

Post offer screening.

A well designed post offer screening program including PDA, clear acceptable criteria, physical screening, standardized objective tests, and occupational and job specific tests can substantially decrease the number of injuries and resulting costs. The results of a study suggest post offer screening makes a difference on post hire injury and resulting costs. These findings are consistent with the literature reviewed. Occupational health professionals are key to the development, implementation, and evaluation of such a program and can directly affect the company's bottom line when employees are accurately matched to their job requirements.